Understanding Heart Attack: Diagnosis and Treatment
How Is a Heart Attack Diagnosed?
If your doctor suspects you are having a heart attack, he or she will promptly run tests, which may include:
ECGor EKG. The electrocardiogram is a simple test that records the electrical activity of the heart. The test can often accurately detect heart irregularities and help pinpoint the area of the heart attack.
Blood tests. Several blood tests, often taken over a period of time, can help diagnose a heart attack and detect any ongoing heart damage.
Often, treatment for heart attack is started at this time. Once you're stabilized, the doctor may recommend a test to pinpoint the location of the blocked artery -- and perhaps unblock it. These procedures may include:
Cardiac catheterization. In this procedure, a catheter (thin, hollow tube) is inserted into a blood vessel in the groin or wrist and threaded up to the heart. Dye is used to highlight the heart's arteries. Blockages can be identified and often treated with angioplasty or stents to open the blocked arteries.
Echocardiogram. In this ultrasound test, sound waves are bounced off the heart to create images. This test can identify significant damage to the heart muscle from the heart attack and identify the presence of heart failure.
Stress testing. Either a treadmill test or a radionuclide scan can assess whether other areas of the heart are still at risk for another heart attack.
What Are the Treatments for Heart Attack?
Emergency Medical Care for a Heart Attack
A heart attack is a medical emergency that requires immediate care to prevent permanent heart damage or death. CPR (cardiopulmonary resuscitation) should be started if the victim goes into cardiac arrest, when the heartbeat has stopped. CPR doesn't restart the heart; it just keeps the victim alive until medical help arrives.
An easy-to-use device called an AED (automated external defibrillator) is now available in many public places and can be used by almost anyone to treat cardiac arrest. This device works by shocking the heart back into a normal rhythm.
Treatment often begins in the ambulance if you called 911, or in the emergency room if someone else took you to the hospital. The first treatment given to a person suspected of having a heart attack is an aspirin. If you have called emergency services and are waiting for them to arrive, chew an aspirin. Aspirin is a potent inhibitor of blood clots and can decrease the risk of death from the heart attack by 25%.
Heart Attack Treatment in the Hospital
At the emergency facility or hospital, a heart attack victim is rapidly given other drugs to prevent further blood clotting in the heart and decrease the strain on the heart. Treatment may also include a procedure to open up the blocked arteries.
Clot-busting drugs. These are given in the ER to open up blocked arteries. These powerful drugs are used if it will take too long to get a victim to the catheterization lab and to perform angioplasty and stenting.
Balloon angioplasty. This treatment can be performed, if needed, during a cardiac catheterization. A balloon-tipped catheter (thin, hollow tube) is inserted into the blocked artery in the heart. The balloon is inflated gently to press plaque outward against the walls of the artery, to open up the artery and improve blood flow.
Stent placement. In this procedure, a wire-mesh tube is inserted through a catheter into a blocked artery to "prop" it open. This procedure is often performed along with balloon angioplasty to help keep the artery open.
Bypass surgery. This surgical procedure allows a surgeon to re-route blood flow around a blocked artery to re-establish blood flow to part of the heart. A blood vessel from the person's leg or chest is usually used to bypass the blocked artery. Bypass surgery is typically done later, not as part of the emergency care of a heart attack. One, two, or more arteries can be bypassed.